Uric acid stones. Urolithiasis disease

One of the types of urolithiasis is urate kidney stones. This anomaly is the 2nd most common in humans. As a rule, it is recorded in the period from 20 to 55 years. Uric acid stones in elderly people are detected in the bladder, and in young people - in the renal organs and ureters. The formation of calculi that are not detected in time are dangerous with severe complications.

General information

Pathologies with metabolic disorders, due to which urate stones and other insoluble compounds in the renal organs are formed, are called urolithiasis. The formation of urates is typical for a strong half of humanity. Urate stones are colored yellow-brown with a relatively smooth structure. The kidney, ureter and ureter are the organs in which uric acid stones form. A dangerous deterioration is the transformation of urate stones into coral stones, which is fraught with diseases such as pyelonephritis and chronic renal failure.

Causes of uric acid kidney stones

An insufficient amount of B vitamins can provoke an anomaly.

According to experts, the emergence of a pathological process in the form of the formation of urate stones in the body is facilitated by various reasons, acting in combination or separately, they include:

• Genetic predisposition. Urolithiasis is inherited, as an example, overestimated levels of calcium in the body (calcium is a building material for calculi in most cases).
• An increase in salt concentration due to a malfunction of metabolic processes. This will lead to disruptions in the natural balance of microelements, a salt precipitate will appear, from which stones will begin to form.
• Monotonous food can serve as a factor in the development of stone formations.
• Place of residence of the person. There are geographical places in which cases of urolithiasis are more often recorded. To avoid this, the body should be kept hydrated.
• The specific composition of the water consumed can influence the progression of the disease.
• Insufficient amount of B vitamins.
• Favorable conditions for the development of the disease - hard work; passive lifestyle; bad habits, fasting.
• The use of a large amount of analgesic drugs.
• Acid reaction of urine. Acidic indicators can be identified using specialized rapid tests. Indicators are normally considered from 6.0 to 7.0.
• Excessive content of uric acid salts in urine. Salts are the end product of protein metabolism in the body, which is always present in urine. To change to an alkaline reaction, you should eat a lot of vegetables, fruits and dairy products.

Symptoms

Nausea and urge to vomit are possible symptoms of urate stones in the body.

The main danger in the occurrence of stones is that symptoms do not appear for a long time. In the later stages, the main symptom of the presence of urate stones in the body is renal colic and its characteristic manifestations:

• sharp pains in the lumbar region;
• painful sensations spread to all organs of the genitourinary system (from the bladder to the adrenal gland);
• a painful attack cannot be stopped;
• the presence of tremors in the body;
• nausea and urge to vomit;
• excessive gassing;
• pain when urinating;
• gout;
• visual deviations from the parameters in urine (turbidity, sandy sediment, bloody spots).

An increase in body temperature is an alarming symptom that speaks of an incipient inflammatory process in the renal organs. The development of renal colic occurs during obstruction of calculus in the normal outflow of urine. At the first sensory or visual changes in the body, you should contact a specialist, the pathology detected in time is corrected much faster than a neglected state.

Diagnostics

For an accurate diagnosis, it is necessary to undergo an examination.

Men are more prone to the formation of urate stones in the body. They associate this with the fact that the male sex has a more pronounced preference for meat and dishes from it. The resulting excess of uric acid provokes the formation of urate calculi and gout. However, women are more likely to suffer a severe form of urolithiasis, namely, large coral-shaped stones. During the diagnosis and selection of effective therapy, one should take into account the existence of chronic diseases, namely ischemic heart disease, diabetes mellitus, obesity, gout and hypertension. To make an accurate diagnosis, an examination is prescribed, consisting of:

• general blood test;
• deep laboratory studies of urine;
• urography (overview and excretory);
• ultrasound examination of the urinary system;
• spiral computed tomography (CT);
• magnetic resonance imaging (MRI);
• contrast fluoroscopy (conventional X-ray is not effective).

Pathology treatment

General principles of conservative treatment

The specificity of the uncomplicated degree of pathology in light dissolutions of urate formations. Conservative methods contribute to the development of a favorable outcome. Uric acid stones dissolve under the influence of the consumption of a large volume of fluid, which triggers a change - the acidic state is converted to alkaline. With this therapy, an important role is played by nutrition, namely, a large consumption of plant and dairy products is introduced into the human diet and the intake of alkaline mineral water. If such measures are not able to dissolve urinary salts, then treatment with medication or surgery is prescribed.

Drug therapy

Medicines can help relieve pain and inflammation.

Treatment of urate kidney stones with drugs is aimed at:

• removal of pain attacks;
• correction of protein metabolism;
• an increase in the rate of formation and volumes of urine;
• removal of inflammatory processes (if any).

To achieve these goals, they resort to antispasmodic drugs to relieve muscle tension in the urinary tract; they turn to uricostatic drugs in case of violation of the exchange of purines; to increase the volume of urine, diuretics are used and antibiotic therapy is prescribed for concomitant inflammatory processes.

Diet for calculi

Adherence to the rules of a special dietary diet is the main measure in the therapy of urate formation, regardless of which treatment is prescribed by the doctor. The diet promotes the dissolution of urate formations. Food should be taken in fractional portions in the amount of 4-6 meals per day. Be sure to include in the diet of such foods:

• legumes;
• bakery products (especially from the highest wheat varieties);
• spinach;
• sorrel greens;
• luke;
• oatmeal;
• fish and seafood;
• spices;
• chocolate products;
• hot drinks (cocoa, tea, coffee);
• table salt.

Foods completely excluded from food:

• fatty meats and their offal;
• rich fish or meat broths;
• alcoholic drinks (beer, red wine).

Almost every second patient with a diagnosis of urolithiasis is faced with the situation when urate stones are formed in the kidneys.

The urate calculi are round in shape, have a smooth surface, and the color varies from yellow to brown.

The risk group includes people of the age category from 20 to 55 years. In elderly patients, urates are diagnosed in the bladder, and in young people - in the kidneys and ureter.

The danger of uric acid stones is the development of complications if a person does not seek qualified help for a long time.

Three factors can most often provoke the formation of urate kidney stones.

Formation of urate stones

1. High acidity of urine. In order to regularly measure the level of urine acidity, experts advise using test strips or a medical device - a hand-held pH meter - at home.

This technique allows you to effectively control and make changes to the nutritional system and the course of therapy. Normal values \u200b\u200brange from 6.0-7.0 pH. During the day, the indicator changes from more acidic (up to 6.4 pH) to more alkaline (from 6.4 pH). If the level of urine acidity is above 5.5 pH, you need to pay attention to the diet. It is best to measure acidity twice: an hour before meals and a few hours after.

If urolithiasis is suspected, urine acidity should be measured twice a week, three times a day.

2. Uraturia - increased content of uric acid salts in urine. If an acidic urine reaction is recorded, this is not a sufficient reason for the formation of urates. Stones appear with a complex of factors: high acidity and the presence of uric acid salts. Salts of this category are present in the body of every person.

Uric acid formation in urine

A favorable condition for their precipitation and the formation of urates is urine acidity below 5.0 pH. To change the reaction of urine from acidic to alkaline, it is enough to add a variety of dairy products to the diet. But the excess amount of meat dishes on the menu contributes to the formation of urates. That is why urate stones are diagnosed in men much more often than in women.

You can neutralize the effect of meat products with vegetables and herbs.

3. Low rate of urine formation. If urine in the body is not formed quickly enough, its concentration exceeds the permissible norm, and this can provoke the formation of urates. In order to speed up the process of urination, you must drink plenty of water. However, it must be borne in mind that excessive fluid intake is contraindicated in patients with pathologies of the cardiovascular system.

Reasons for the increase in urate formation

Other factors contributing to the formation of urates:

- lack of vitamin B;

- a long course of treatment with analgesics;

- improper nutrition;

- sedentary lifestyle.

In severe cases, urates transform into dangerous coral stones, which in turn cause pyelonephritis and even kidney failure.

Symptoms of the disease

Urolithiasis, in spite of the chemical composition of calculi, takes a long time without pronounced symptoms. As a rule, the patient learns about the disease only when renal colic begins.

Blockage of the ureter with a stone - renal colic

• discomfort in the lumbar region, manifested on one side;
• discomfort extends to the abdomen, bladder and genitals;
• pain cannot be eliminated with drugs, a person cannot find a comfortable position to relieve pain;
• chills;
• nausea and vomiting;
• flatulence;
• high body temperature (appears with an inflammatory process in the kidneys).

Renal colic occurs when calculus prevents urine from flowing out of the body.

Diagnosis of pathology

To identify urolithiasis and establish the chemical composition of calculi, a set of diagnostic measures is used:

• ultrasound examination of the kidneys;
• detailed analysis of urine and blood;
• urography;
• cT scan;
• magnetic resonance imaging;
• radiography of the kidneys using a contrast agent.

Standard X-ray examination does not provide an opportunity to detect urate stones.

Treatment

Considering the peculiarity of urates easily dissolve in water, as a rule, the treatment of urate kidney stones does not require procedures involving penetration into the body.

Thus, it is possible to achieve complete dissolution of uric acid stones in the kidneys.

Also, a course of conservative therapy involves:

• taking medicinal decoctions of medicinal herbs that have a diuretic effect;
• the appointment of a therapeutic diet based on dairy products, fresh vegetables and the complete absence of meat and offal;
• the drink must be alkaline.

Surely, many of you have heard of such a disease as gout. But not everyone is aware that it occurs due to deposits of uric acid in the joints. Pathogenesis of increased blood urate, risk factors and treatment.

Read about the essence of the intravenous urography method. How to choose an X-ray contrast and how is the procedure performed?

In this article, you will learn all about the causes of urolithiasis in women. Treatment and diet for urolithiasis.

Therapeutic diet for urates

Therapeutic diet for urate kidney stones is not just one of the stages of therapy, but a way of life. There are three categories of products: prohibited, conditionally allowed, and healthy.

Diet for uric acid stones

The basic principle for dividing food is the amount of animal protein in the food. The higher the protein level in a product, the more dangerous it is for a patient with kidney urate.

List of permitted food items:

• fresh vegetables, berries and fruits;
• dairy products;
• cereals;
• pasta;
• coarse bread;
• vegetable, fruit and berry juices;
• compotes;
• weak tea with lemon.

List of foods that need to be limited

• bakery products made from wheat flour;
• legumes;
• spinach, sorrel and onions;
• fish;
• chocolate;
• spices;
• spicy dishes;
• salt;
• strong tea.

List of Prohibited Foods

• alcoholic drinks;
• fatty meats;
• offal: kidneys, liver, heart, lungs;
• too saturated meat and fish broths;
• animal fat;
• canned and pickled foods;
• mushrooms.

In addition, you should drink at least two and a half liters of any liquid.

Treatment with folk methods

Herbs are widely used in the treatment of urate stones, which have a diuretic and anti-inflammatory effect on the body. For this purpose, you can prepare decoctions and infusions of lingonberry leaves, horsetail, bearberry and, of course, half-burnt.

The benefits of lingonberry for the kidneys

Very often, such herbal medicine contributes to the complete dissolution or removal of stones from the body.

Disease prevention

Treatment of urate calculi involves the observance of preventive measures aimed at eliminating the likelihood of re-formation of urate.

1. Drink as much as possible. Often, the recommended daily volume of fluid for an adult is 1.5 liters. However, this volume is only enough to maintain the natural metabolic processes in the body. When it comes to high-quality flushing of the kidneys, elimination of toxins and toxins, ensuring filtration, this amount of water is not enough. Drink at least two and a half liters of liquid.
2. Avoid hypothermia of the kidneys.
3. Avoid the development of infectious diseases.
4. Constantly adhere to a therapeutic diet.
5. Exercise regularly.

Only strict adherence to all preventive measures guarantees full recovery, and also significantly reduces the risk of urate calculi formation and possible complications in the future.

Video on the topic

In healthy people, urinary stones are not found in the urine.

Urinary tract stones are insoluble components of urine of various chemical composition. The emergence of insoluble formations occurs according to the scheme: supersaturated solution (non-crystalline form) → formation of small crystals (nucleation process) → the emergence of large crystals and even their aggregates (crystal growth and their conglomeration).

The formation of small crystals is facilitated by the so-called epitaxic induction, based on the similarity of the shape of the constituents of a crystallized solution, regardless of their chemical composition. For example, crystals of uric acid, calcium oxalate and calcium phosphate, which have a similar shape, interfere with the formation of stones. In addition to compounds that facilitate the formation of crystals (promoters), there are substances that interfere with this process (inhibitors). These include pyrophosphates, ATP, citrate, glycosaminoglycans (especially heparin, hyaluronic acid, and dermatan sulfate).

When examining urinary stones, first of all, their size is noted, then the color, surface properties, hardness, and the type of cross-cuts. The following types of stones are most commonly identified.

• Oxalate stones (from calcium oxalate), they account for up to 75% of cases of stones formed by calcium salts. They are either small and smooth, or large (up to several centimeters) and have a large warty surface. In the latter case, they have a complex chemical composition, and oxalates form only surface layers. Compared to other stones, they are distinguished by the greatest hardness. The most common cause of oxalate stones is increased urinary calcium excretion, which may be due to increased intestinal calcium absorption, impaired intestinal filtration and resorption, or unrecognized hyperparathyroidism. In these cases, against the background of hypercalciuria, an increased intake of oxalates with food creates additional favorable conditions for the formation of stones. An increased amount of oxalates in the body can be formed with an overdose of vitamin C (more than 3-4 g / day). Calcium oxalate crystals can also form in patients with gout (induction is caused by sodium urate crystals). Excessive formation of oxalates in the body due to congenital insufficiency of enzymes that catalyze the deamination of glycine and thereby lead to an increase in the content of oxalates in the blood is extremely rare.
• Urate stones (from uric acid salts and uric acid), they account for up to 10% of cases of urolithiasis. Their size and shape are very different. Bladder stones can range in size from a pea to a goose egg. In the kidney, they can fill the entire renal pelvis. The color of urate stones is usually grayish-yellow, yellow-brown or red-brown, the surface is sometimes smooth, more often it is rough or finely warty. They are very hard and difficult to cut. The cross-section shows small concentric layers of different colors. The causes of urate stones are different: excessive formation of uric acid in the body, increased intake of purines from food, with gout, especially in cases where substances that prevent the reverse resorption of uric acid in the renal tubules are prescribed for therapeutic purposes. The formation of stones is facilitated by acidic pH values \u200b\u200bof urine and its small amount. There are 4 types of uric acid urolithiasis.
  • Idiopathic, in which patients have a normal concentration of uric acid in blood serum and urine, but urine pH is constantly lowered; this type also includes patients with chronic diarrhea, ileostomies, as well as those receiving medications that acidify urine.
  • Hyperuricemic, in patients with gout, myeloproliferative diseases, and Lesch-Nyen syndrome. About 25% of patients with gout symptoms have uric acid stones, and 25% of patients with uric acid stones have gout. If the daily excretion of uric acid in a patient with gout exceeds 1100 mg, the frequency of urolithiasis is 50%. In addition, an increase in the concentration of uric acid in the blood and urine is possible in patients receiving chemotherapy for neoplasms.
  • With chronic dehydration. Concentrated, acidic urine is common in patients with chronic diarrhea, ileostomata, inflammatory bowel disease, or excessive sweating.

• Hyperuricosuric without hyperuricemia is observed in patients receiving uricosuric preparations (salicylates, thiazides, probenecid) or eating foods rich in purines (meat, sardines).
• Phosphate stones (from calcium phosphate and tripel phosphate). Calcium phosphate crystals are rarely detected, in about 5% of cases. They can reach a significant size, their color is yellowish-white or gray, the surface is rough, as if covered with sand, the consistency is soft, rather brittle, the cut surface is crystalline. They usually form around a small uric acid stone or foreign body. The reasons for their occurrence are in many ways the same as for urate stones.
• Cystine stones are rarely detected, in 1-2% of cases of urolithiasis. Cystine stones can reach considerable size, their color is white or yellowish, the surface is smooth or rough, the consistency is soft like wax, the cut surface seems crystalline. Cystine stones appear when a congenital disorder of cystine resorption in the cells of the proximal renal tubules occurs. Along with cystine, the resorption of lysine, arginine and ornithine is impaired. Cystine is the least soluble amino acid of all of the above, so its excess amount in urine is accompanied by the formation of hexagonal crystals (a diagnostic sign of cystinuria).
• Infectious (struvite) stones are found relatively often, in 15-20% of cases of urolithiasis (in women, 2 times more often than in men). Struvite stone consists mainly of ammonium and magnesium phosphate, their formation indicates the presence at the time of the study or a pre-existing infection caused by bacteria that break down urea (most often - Proteus, Pseudomonas, Klebsiella). Enzymatic cleavage of urea by ureases leads to an increase in the concentration of bicarbonates and ammonium, which contributes to an increase in urine pH above 7. In an alkaline reaction, urine is oversaturated with magnesium, ammonium, phosphates, which leads to the formation of stones. Struvite stones are formed only with an alkaline reaction of urine (pH more than 7). Approximately 60-90% of coral stones are struvite. Establishing the chemical composition of urinary stones allows the attending physician to navigate in the selection of a diet for a patient with urolithiasis. High dietary protein intake (1-1.5 g / kg per day) can increase urinary sulfates and uric acid. High concentrations of sulfates and uric acid can promote the formation of oxalate stones. Sulfates cause acidosis, which decreases urinary citrate. Taking calcium supplements, which is recommended for the prevention and treatment of osteoporosis, can lead to hypercalciuria. High oxalate content in food enhances calcium oxalate crystalluria. All this must be taken into account when choosing a diet, since only proper nutrition helps to restore metabolism.

Uric acid stones are different from all other urinary tract stones in that they can dissolve with appropriate diet and therapies. The objectives of treatment are to increase the pH of the urine, increase its volume and decrease the excretion of uric acid with it. With uraturia, the patient is advised to exclude foods that contribute to the formation of uric acid (brains, kidneys, liver, meat broths). In addition, it is necessary to strictly limit the consumption of meat, fish, vegetable fats, which shift the pH of urine to the acidic side (in the presence of urates, the pH of urine is 4.6-5.8), and since in such patients the amount of citrates in the urine is reduced, this promotes crystallization of uric acid. It must be remembered that a sharp shift in urine pH to the main side leads to the precipitation of phosphate salts, which, enveloping urates, make it difficult for them to dissolve.

With oxalate stones, it is necessary to limit the intake of foods with a high content of oxalic acid salts (carrots, green beans, spinach, tomatoes, sweet potatoes, rhubarb root, strawberries, grapefruit, oranges, cocoa, cranberry juice, raspberry juice, tea). In addition to dietary restrictions, magnesium salts are prescribed, which bind oxalates in the intestine and limit their absorption.

With phosphaturia and phosphate stones, urine has a basic reaction. To change the main reaction of urine to acidic, preparations of ammonium chloride, ammonium citrate, methionine, etc. are prescribed (under the control of urine pH).

In many patients, cystine stones can be prevented and even dissolved. To reduce the concentration of cystine, you should drink 3-4 liters of liquid per day. In addition, urine must be alkalized, as cystine dissolves better in alkaline urine. If cystine stones form or grow in size, despite the intake of large amounts of fluids and alkalizing therapy, drugs that bind cystine and form a more soluble cysteine \u200b\u200b(penicillamine, etc.) should be prescribed.

Rational therapy of urinary tract infections is necessary to prevent the formation and growth of struvite stones. It should be noted that bacteria are present on the surface of the stone and can persist there even after the completion of the course of antibiotic therapy and the disappearance of the pathogen in the urine. After stopping therapy, bacteria again enter the urine and cause a relapse of the disease. Patients with intractable urinary tract infections are prescribed urease inhibitors, which block the corresponding bacterial enzyme, which leads to acidification of urine and dissolution of stones.

Currently, the incidence rate of urolithiasis () among the population of our country, according to medical statistics, reaches 20-30%, which experts associate with a deterioration in the quality of drinking water and an unfavorable environmental situation in general. One of the significant exogenous factors is an excess of heavy metal compounds (in particular, lead), the accumulation of which in the body inevitably leads to various disorders of metabolic processes.

Causes of kidney stones

With urolithiasis, urate kidney stones are often formed. In terms of the frequency of occurrence, calculi of this composition take the next place after the most common. They are most often diagnosed in patients of young and mature age (from 20 to 50 years). In the elderly and in pediatric patients, deposits are more likely to occur in the bladder. In many cases, the first signs of the development of the disease are intense pain.

Urate stones are formed from uric acid salts against the background of their increased concentration. The direct causes of calculus formation include the low pH (acidic reaction) of urine and a slowdown in its formation.

note: now it is possible to timely identify an increased likelihood of developing pathology, regularly determining the reaction of urine an hour before a meal using test strips.

Uric acid compounds (urates) are derivatives of the normal metabolism of protein compounds, so they are always present in the body in a certain amount, and it is not possible to completely get rid of them. You can prevent the formation of urate stones and sand in the kidneys by eating foods that shift the pH of urine to the alkaline side.

Important: normal urine has an alkaline reaction (6.0-7.0). Above pH 5.5 (neutral), the probability of urate formation is low.

If the formation of urine proceeds at an insufficient rate, then its concentration and the percentage of urate content in it increase. As a result, salts precipitate, gradually forming a dense formation. In such situations, the degree of acidification of urine can be reduced by consuming a large amount of fluid (at least one and a half liters per day, and at least two in hot weather).

Factors predisposing to the formation of urate deposits include:

• hypodynamia (sedentary lifestyle);
• starvation;
• the use of some analgesics in doses exceeding the recommended ones;
• lack of B vitamins;
• inappropriate nutrition (in particular - the consumption of animal protein in large quantities).

note: hypodynamia leads to disruption of various metabolic processes, in particular - the metabolism of phosphorus and calcium.

Specific features of uric acid kidney stones

Urate deposits are usually round and smooth. The size of calculi can vary from 1-2 mm to several centimeters. The urates are characterized by a yellow-brown color and a rather loose structure.

Clinical picture

Uric acid stones may not make themselves felt for a long time. Symptoms in most cases develop unexpectedly.

The patient develops renal colic with characteristic symptoms:

• intense (as a rule - one-sided, from the side of the affected organ, but "encircling" is not excluded);
• pain "gives" to the abdominal region (abdomen), bladder and genitals;
• pain syndrome is almost impossible to remove;
• the patient develops chills;
• changing posture does not bring relief;
• in some cases, there are dyspeptic disorders (nausea, vomiting).

Important: hyperthermia (increase in general body temperature) against the background of colic with a high degree of probability indicates the development of an acute inflammatory process in the tissues of the kidney.

Renal colic is caused by an obstruction (blockage) of the urinary tract with a stone, which prevents the passage of urine.

One of the possible symptoms may be gross hematuria, that is, the presence of blood in the urine.

Possible complications

The progression of the pathological process can lead to the transformation of deposits in the so-called. coral stones filling a significant volume of the kidney.

As a consequence, the development of an acute inflammatory process in the renal pelvis () and.

Diagnostics

Uric acid stones are more often found in male patients. This is due to the fact that many men prefer meat products, while they consume relatively little fruit, vegetables and dairy products.

Excess uric acid not only leads to the formation of urates, but also causes gout (develops when uric acid salts are deposited in the joints). The incidence of gout is also higher among men.

Note: in women, severe forms of urate nephrolithiasis are more common - large coral formations.

To identify the nature of the pathology, there is usually not enough history data.

Diagnosis of uric acid stones includes:

• deep laboratory examination of the patient's urine;
• conducting a survey and excretory urography;
• Ultrasound of the kidneys;
• spiral CT ();
• MRI (magnetic resonance imaging);
• contrast fluoroscopy.

note: Routine X-ray examination in most cases is uninformative.

When making a diagnosis and the subsequent choice of treatment tactics, it is necessary to take into account the presence of concomitant diseases, such as:

• coronary artery disease;
• gout.

Treatment for kidney stones

Therapy for urate deposits differs from the treatment for other types of stones.

General principles of conservative treatment

One of the specific features of urates is their relatively easy dissolution, therefore, in most cases, conservative measures can achieve a positive effect.

The dissolution of urate kidney stones involves the consumption of large volumes of fluid in order to shift its pH towards the alkaline side. In addition, the patient is shown a diet in which a large amount of dairy and plant foods should be included in the diet (such foods contribute to the alkalinization of urine). Shown are alkaline mineral waters.

Alternative treatment of kidney stones

Diuretic herbs include field horsetail and bearberry. A decoction of lingonberry leaves is also an effective diuretic.

Diet for kidney stones

Compliance with a specific diet is considered one of the main ways to dissolve uric acid stones in the kidney and ureter.

Foods and drinks that should be excluded from the diet:

• fatty pork and beef;
• animal products rich in purine bases (liver, kidneys, veal);
• fish and meat broths;
• offal;
• canned food;
• red wine;
• beer.

Products, the consumption of which is advisable to reduce:

• legumes (, peas,);
• bakery products (especially from the highest grades of wheat);
• fish and seafood;
• spice;
• chocolate and cocoa;
• strong tea.

Foods that must be included in the diet to remove uric acid stones from the kidneys:

• eggs;
• milk and fermented milk drinks;
• cottage cheese;
• pasta;
• any fruit;
• seeds;
• wheat and buckwheat groats;
• foods rich in ascorbic acid (, rose hips, etc.);

note: for treatment and prophylaxis, fractional nutrition is shown, which involves eating in small portions 5-6 times a day.

Treatment of urate kidney stones with tablets

Acute symptoms can help reduce antispasmodics and anti-inflammatory drugs. Antispasmodic drugs relax the smooth muscles of the urinary tract, one hundred helps to reduce the obstruction of the duct and accelerate the excretion of stones and sand in a natural way.

If violations of purine metabolism are detected, drugs from the group of uricostatics (Allopurinol) are prescribed. The presence in the urine of high concentrations of urates and oxalates is an indication for the use of magnesium oxide, and if there is a high content of calcium salts, then Hypothiazide is prescribed (standard dosages).

Patients are shown the reception of the so-called. "Citrate mixtures" for alkalizing urine and maintaining its pH in the range of values \u200b\u200bfrom 6.2 to 6.8.

Surgery

To remove kidney stones, surgery can be a forced measure, which is resorted to in 3-5% of cases. Surgery is necessary if large coral formations are present. Crushing of kidney stones with ultrasound and laser (lithotripsy) is also used relatively rarely.

With urate kidney stones, the size of which does not exceed 2.5 cm, minimally invasive distance lithotripsy is successfully used, which allows to destroy the calculus.

Prevention

It is not enough to know how to remove kidney stones; you need to have a good idea of \u200b\u200bhow to prevent a relapse of the disease. The re-formation of urate stones helps prevent adherence to the drinking regime. For the normal course of metabolic processes, an adult needs to drink at least one and a half liters of liquid a day (preferably pure water). However, to accelerate the elimination of toxic metabolic products, that is, to cleanse the body of toxins, about two and a half liters are needed.

note: you can and should drink a lot of fluids, unless there is a diagnosed renal failure (acute or chronic form), a tendency to edema and problems with the cardiovascular system.

In the hot season, it is better to “wash the body” in relatively cool morning and evening hours. In this case, most of the fluid will be excreted through the urinary system, and not by the sweat glands.

In addition, it is advisable to reduce the consumption of fatty, spicy, fried and salty. It is also recommended to avoid spicy foods. Preference should be given to drinks with an alkaline reaction (mineral waters), and the consumption of soda, which contains, for example, phosphoric acid ("Coca-Cola", etc.) should be minimized.

Konev Alexander, therapist

Urolithiasis (the formation of kidney stones) refers to diseases associated with impaired metabolic processes in the body, and in recent years is considered a disease of the century. Up to 5-10% of cases of detection of urinary tract stones are patients with uric acid stones.

People get sick with this disease and other mammals do not get sick. The fact is that humans, unlike other mammals, do not have a special hepatic enzyme, uricase, which converts water-insoluble uric acid into allantoin, which is easily dissolved and excreted by the kidneys. The consequence of such an enzymatic defect is a more than 10-fold increase in uric acid concentration in humans (and in Dalmatian dogs) compared to other mammals.

Uric acid is a weak acid with a pKa of 5.75. If the urine pH is equal to the pKa of uric acid, half of the molecules are in the insoluble acid form and the other half in the soluble salt form. As the urine becomes more acidic, more acid becomes insoluble. In patients with uric acid stones, urine is constantly acidic, its pH is less than 6.0 and is often 5.0.

Some researchers believe that the mechanism of such a disorder is a deficiency in the production of ammonium by the kidneys, which is a buffer in the urine. The formation of a uric acid stone is associated with a shift in urine pH to the acidic side, a small volume of urine and an increased concentration of uric acid. Probably the most important factor and most common problem associated with uric acid formation is persistently acidic urine.

However, for the formation of uric acid crystals and subsequent stone formation, a combination of all three components is necessary. When carrying out the treatment of urolithiasis, it must be remembered that uric acid stones are unique. Compared to all other urinary tract stones, they dissolve easily with appropriate diet and therapeutic treatment. The objectives of treatment are to increase the pH of urine and decrease the concentration of uric acid while decreasing its excretion in the urine and increasing the volume of urine. For this, patients should increase their fluid intake to values \u200b\u200bexceeding 1500-2000 ml / day.

Increased urination leads to a slight increase in urine pH due to the diuretic effect of water. Uric acid stones usually form at a urine pH of 5.0-5.5. Various drugs are used to alkalize urine, the choice depends on the clinical situation. Nitrazine test strips can be used to monitor urine pH between 6.5 and 7.0.

Excessive alkalization can be harmful, since the patient can form stones that precipitate in alkaline solutions, such as calcium oxalate. Diet. Convince the patient to follow a low purine diet with a protein restriction of 90 grams per day. Patients should reduce their intake of red meat, beef, chicken, and peanuts.